Method and medical agent for diagnosis of arthritis

ABSTRACT

A method and medical agents for the photodynamic diagnosis of rheumatoid arthritis of mammals, which agent comprises at least one member of fluorescent compounds selected from the group consisting of tetrapyrrole carboxylic acids having at least one carboxyl group, corresponding di- or tetrahydrotetrapyrrole carboxylic acids, and mono-, di- or polyamides of the tetrapyrrole carboxylic acids with amino-mono- or dicarboxylic acids and their salts.

This is a divisional of application Ser. No. 08/229,940, filed on Apr. 19, 1994, now U.S. Pat. No. 5,430,051.

BACKGROUND OF THE INVENTION

(1) Field of the Invention

This invention relates to a method and medical agents for the photodynamic diagnosis and photodynamic therapy of the arthritis, especially the arthritis of mammals. More particularly, the medical agents used in the present invention belong to specific fluorescent compounds having a tetrapyrrole skeletal structure. When an effective quantity of the medical agent is administered to an animal patient, the agent is accumulated in the affected part of the body.

When light rays of necessary wavelength are applied to an affected joint to be diagnosed or treated, the agent generates fluorescence in the affected portion, thereby enabling the detection of arthritis. This is called as photodynamic diagnosis. In the therapeutic treatment, when light rays of appropriate wavelength and intensity are applied to a lesion, the agent is excited to produce a cytotoxic effect and the affected cells in arthritic lesion are necrosed. This is called as photodynamic therapy. The present invention relates to the diagnosis and the therapy of this kind applied to arthritis, especially rheumatoid arthritis.

(2) Description of the Prior Art

Rheumatoid arthritis is a chronic systemic disease mainly causing to occur polyarthritis as a cardinal symptom. This disease is initiated by the pain and swelling in small joints of hands and feet, or in elbow joints and knee joints, and other joints in whole body are then affected little by little. In the initial phase of the disease, the hyperplasia of the synovia of the affected joint begins by some stimulation of the unknown antigen, and the synovial hyperplasia is maintained and prolonged by the monokine cascade system to be a tumor-like condition. The constituents of the joint such as cartilage or ligament or bone are destroyed by the enzymes produced by these synovia and followed by the destruction of the joints.

This pathological condition is observed in all human races and distributed all over the world.

In the diagnosis of the rheumatoid arthritis, it is necessary to identify the outbreak of rheumatoid factor and the existence of inflammatory response by means of blood test, the occurrence of swelling and pain in joints, and further the existence of distortion of bones by means of X-ray inspection. In view of the results of these inspections, the diagnosis of rheumatoid arthritis can be attained.

Since any satisfactory etiologic therapy for the rheumatoid arthritis has not been developed, the nosotropic treatment to preserve affected lesions is employed according to respective cases. However, the efficacy of such treatments is no yet clarified at present. That is, in the first place, medication is done in order to promote the remission of disease by administering a non-steroidal antiphlogistic lenitive, at the same time, the physiotherapy is adopted. In spite of the medication, if the swelling takes a bad turn and the hyperplasia of synovial membrane become noticeable, synovectomy is carried out by arthrotomy or by arthroscopic method. The total arthroplasty is employed in order to restore the function of the joint by substituting the artificial prosthesis for the destructed joint.

In order to prevent the destruction of the joint constituents, the cellular immunologic responses in the synovia must be reduced throughout the disease process, especially in the early stage.

There is hitherto known a method of diagnosis and therapy of rheumatoid arthritis by administering a hematoporphyrin derivative to rats which suffer from adjuvant induced arthritis and applying light rays to the rats. For instance, "Rheumatoid Arthritis and Laser (Effect of laser irradiation to adjuvant induced arthritis)", The RYUMACHI (Official Journal of the Japan Rheumatism Association), Vol. 23, pp 574-575, 1983.

However, it was clarified through the experiments carried out by the present inventors that, when a typical hematoporphyrin derivative, Photofrin II, is used, it cannot be taken selectively into a rheumatoid arthritic lesion and a noticeable therapeutic effect to the rheumatoid arthritis cannot be expected.

Incidentally, the compounds themselves used in the present invention are already known as diagnostic and therapeutic medicines for cancer. However, the inventors have never known any instance concerning the use of the relevant compounds for the diagnosis and treatment of arthritis. The field of art according to the present invention is, of course, different from the field of art in the diagnosis and the therapy of cancer.

Furthermore, the inventors are acquainted with the following literatures, however, the object of the studies are different from that of the present invention.

(a) "Systemic Immunosuppression Induced by Photodynamic Therapy (PDT) is Adoptively Transferred by Macrophages", PHOTOCHEMISTRY AND PHOTOBIOLOGY, Vol. 49, pp 453-458, 1989.

(b) "Immunological Suppression in Mice Treated with Hematoporphyrin Derivative Photoradiation", CANCER RESEARCH, Vol. 46, pp 1608-1611, 1986.

BRIEF SUMMARY OF THE INVENTION

It is, therefore, the object of the present invention to provide a medical agent for use in the diagnosis and the therapy of the above-mentioned rheumatoid arthritis. The present invention further propose a medical agent for the photodynamic diagnosis and photodynamic therapy of arthritis, especially rheumatoid arthritis, in which the conventional diagnostic method to use arthroscopes and synovectomy are sometimes employed.

In view of the above object, the present inventors have carried out extensive investigations and, as a result, they have found out a novel utility of medical agents, which agents are effective to the photodynamic diagnosis and photodynamic therapy of rheumatoid arthritis.

The present invention, therefore, provides a medical agents for use in the diagnosis and therapy of rheumatoid arthritis of mammals. The agents comprise at least one member of fluorescent compounds selected from the group consisting of tetrapyrrole carboxylic acids having at least one carboxyl group represented by the following general formula, corresponding di- or tetrahydrotetrapyrrole carboxylic acids, and mono-, di- or polyamides of said tetrapyrrole carboxylic acids with amino-monocarboxylic acid or amino-dicarboxylic acids, and their salts. ##STR1##

In the formula, R₁ is methyl, ##STR2##

R₂ is H, vinyl, ethyl, --CH(OH)CH₃, acetyl, ##STR3## --CH₂ CH₂ COOH or ═CHCHO;

R₃ is methyl, ##STR4##

R₄ is H, vinyl, ethyl, --CH(OH)CH₃, --CH₂ CH₂ COOH, ═CHCHO or ##STR5##

R₅ is methyl;

R₆ is H, --CH₂ CH₂ COOH, --CH₂ C₂ COOR or --COOH;

R₇ is --CH₂ CH₂ COOH, --CH₂ CH₂ COOR or ##STR6##

R₈ is methyl or ##STR7##

R₉ is H, --COOH, --CH₂ COOH or methyl;

provided that when R₁, R₂, R₃, R₄, R₇ and R₈ represent two substituents or are divalent and attached to the same carbon, the respective pyrrole ring to which attached is a dihydropyrrole;

R is lower alkyl or benzyl;

R₆ and R₉, taken together are ##STR8## with the proviso that at least one of R₁ to R₉ is a free carboxyl group.

DETAILED DESCRIPTION OF THE INVENTION

All the medical agents used in the present invention are fluorescent compounds, which are represented by the foregoing general formula. The tetrapyrrole carboxylic acid has at least one and preferably three carboxyl groups and it is desirable that the carboxyl groups are connected asymmetrically. For example, the carboxylic acid groups are present on the rings A and B side of the molecule or on the rings C and D side of the molecule.

Also included in the compounds of the present invention are di- and tetrahydro-tetrapyrrole carboxylic acids which correspond to the above tetrapyrrole. Furthermore, pharmaceutically acceptable salts of the carboxyl groups of these carboxylic acids such as the salts of alkali metals, alkaline earth metals, ammonium and amines are included.

Furthermore, the compounds which is used in the present invention are mono-, di- and polyamides of amino monocarboxylic acids with the above tetrapyrrole carboxylic acids. Another usable groups of compounds are mono-, di- and polyamides of amino dicarboxylic acids with the same tetrapyrrole carboxylic acids as above. Furthermore, pharmaceutically acceptable salts of the carboxyl groups of these mono-, di or polyamides such as the salts of alkali metals, alkaline earth metals, ammonium and amines are included.

The above amino monocarboxylic acids which forms mono-, di- or polyamide by connecting with the above tetrapyrrole carboxylic acid by way of amide bonds are exemplified by serine, glycine, α-alanine, β-alanine, ε-amino-n-caproic acid, piperidine-2-carboxylic acid, piperidine-6-carboxylic acid, pyrrole-2-carboxylic acid, piperidine-6-propionic acid, pyrrole-5-acetic acid, and similar such acids. The preferred amino monocarboxylic acids are naturally occurring α-amino monocarboxylic acids, e.g., serine, alanine and glycine, which are readily available and provide the best results.

Exemplified as amino dicarboxylic acids are α-aminosuccinic acid (aspartic acid), α-aminoglutaric acid (glutamic acid), β-aminoglutaric acid, β-aminosebacic acid, 2,6-piperidine dicarboxylic acid, 2,5-pyrrole dicarboxylic acid, 2-carboxypyrrole-5-acetic acid, 2-carboxypiperidine-6-propionic acid, α-aminoadipic acid, and α-aminoazelaic acid. The preferred amino dicarboxylic acids are the naturally occurring α-amino dicarboxylic acids such as aspartic acid and glutamic acid. These compounds are easily available and produce best results.

The especially preferable tetrapyrrole compounds used in the present invention are represented by the following general formula. ##STR9## wherein, X is H, vinyl, ethyl, acetyl or formyl; Y is methyl or formyl; M is methyl; and E is ethyl.

Typical compounds of the tetrapyrrole classes are shown in Tables 1 and 2 in which the numbered positions of the tetrapyrrole ring structure are used to designate the position of the indicated substituent. The absence of double bonds in the ring system is designated under "dihydro" with each set of numbers (ring position) indicating the absence of a double bond between designated positions.

                                      TABLE 1                                      __________________________________________________________________________                   Ring Position                                                                  A          B             C         D                             Porphyrin       1    2     6     7     11 12  14   16  17 Dihydro              __________________________________________________________________________     Coproporphyrin III                                                                             Me   Pr    Me    Pr    Me Pr  H    Pr  Me --                   Deuteroporphyrin IX                                                                            Me   H     Me    H     Me Pr  H    Pr  Me --                   Hematoporphyrin IX                                                                             Me                                                                                   ##STR10##                                                                           Me                                                                                    ##STR11##                                                                           Me Pr  H    Pr  Me --                   Protoporphyrin IX                                                                              Me   V     Me    V     Me Pr  H    Pr  Me --                    Photoprotoporphyrin IX     Me                                                                 Me   V           CHCHO Me Pr  H    Pr  Me 6,7                  (one of two isomers shown) OH                                                  Mesoporphyrin IX                                                                               Me   Et    Me    Et    Me Pr  H    Pr  Me --                                    Me   Et                                                       Transmesochlorin IX        Me    Et    Me Pr  H    Pr  me 1,2                                  H    H                                                                                     H     H                                            Transmesochlorin IX                                                                            Me   Et                Me Pr  H    Pr  Me 6,7                                             Me    Et                                                                                                H   H                      Chlorin e.sub.4 Me   V     Me    Et    Me CO.sub.2 H                                                                         Me          16,17                                                                   Pr  Me                                                                          H   H                      Chlorin e.sub.6 Me   V     Me    Et    Me CO.sub.2 H                                                                         Ac          16,17                                                                   Pr  Me                                                                          H   H                      Mesochlorin e.sub.4                                                                            Me   Et    Me    Et    Me CO.sub.2 H                                                                         Me          16,17                                                                   Pr  Me                                                                          H   H                      Isochlorin e.sub.4                                                                             Me   V     Me    Et    Me H   Ac          16,17                                                                   Pr  Me                      __________________________________________________________________________

                                      TABLE 2                                      __________________________________________________________________________                 Ring Position                                                                  A      B        C        D                                         Porphyrin   1  2     6    7 11 12  14  16  17 Dihydro                          __________________________________________________________________________                                             H   H                                  Mesoisochlorin e.sub.4                                                                     Me Et    Me   Et                                                                               Me H   Ac         16,17                                                                   Pr  Me                                                                          H   H                                  Mesochlorin e.sub.6                                                                        Me Et    Me   Et                                                                               Me CO.sub.2 H                                                                         Ac         16,17                                                                   Pr  Me                                                        H    H            H   H  6,7                             Bacteriochlorin e.sub.6                                                                    Me ACL          Me CO.sub.2 H                                                                         Ac                                                               Me   Et           Pr  Me 16,17                                                  H    H            H   H  6,7                             Bacteriochlorin e.sub.4                                                                    Me ACL          Me CO.sub.2 H                                                                         Me                                                               Me   Et           Pr  Me 16,17                                                  H    H            H   H  6,7                             Bacterioisochlorin e.sub.4                                                                 Me ACL          Me H   Ac                                                               Me   H            Pr  Me 16,17                             2-Desvinylchlorin e.sub.6              H   H                                              Me H     Me   Et                                                                               Me CO.sub.2 H                                                                         Ac         16,17                            (or Deuterochlorin e.sub.6)            Pr  Me                                                                          H   H                                  2-Acetylchlorin e.sub.6                                                                    Me ACL   Me   Et                                                                               Me CO.sub.2 H                                                                         Ac         16,17                                                                   Pr  Me                                                                          H   H                                  2-Formylchlorin e.sub.6                                                                    Me CHO   Me   Et                                                                               Me CO.sub.2 H                                                                         Ac         16,17                                                                   Pr  Me                                  __________________________________________________________________________      Notes:                                                                         Me: --CH.sub.3 (Methyl group)                                                  Et: --CH.sub.2 CH.sub.3 (Ethyl group)                                          Pr: --CH.sub.2 CH.sub.2 COOH (Propionic acid group)                            Ac: --CH.sub.2 COOH (Acetic acid group)                                        V: --CH═CH.sub.2 (Vinyl group)                                             ACL: CH.sub.3 --CO-- (Acetyl group)                                      

The amides used as the diagnosistic or therapeutic agents according to the present invention are exemplified in the following. In the first place, the amides with amino monocarboxylic acids are exemplified.

Chlorin Derivatives:

(D,L)-Serinyl-trans-mesochlorin IX

Glycyl-trans-mesochlorin IX

α-(D,L)-Alanyl-trans-mesochlorin IX

β-Alanyl-trans-mesochlorin IX

ε-Amino-n-caproyl-mesochlorin IX

(D,L)-Serinyl chlorine₆

(D,L)-Serinyl mesochlorin e₆

Glycyl chlorine₆

Glycyl mesochlorin e₆

α-(D,L)-Alanyl chlorine₆

α-(D,L)-Alanyl mesochlorin e₆

β-Alanyl chlorine₆

β-Alanyl mesochlorin e₆

ε-Amino-n-caproyl chlorine₆

ε-Amino-n-caproyl mesochlorin e₆

(D,L)-Serinyl chlorine₄

(D,L)-Serinyl mesochlorin e₄

(D,L)-Serinyl isochlorin e₄

(D,L)-Serinyl mesoisochlorin e₄

Glycyl chlorine₄

Glycyl mesochlorin e₄

Glycyl isochlorin e₄

Glycyl mesoisochlorin e₄

α-(D,L)-Alanyl chlorine₄

α-(D,L)-Alanyl mesochlorin e₄

α-(D,L)-Alanyl isochlorin e₄

α-(D,L)-Alanyl mesoisochlorin e₄

β-Alanyl chlorine₄

β-Alanyl mesochlorin e₄

β-Alanyl isochlorin e₄

ε-Alanyl mesoisochlorin e₄

ε-Amino-n-caproyl chlorine₄

ε-Amino-n-caproyl mesochlorin e₄

ε-Amino-n-caproyl isochlorin e₄

ε-Amino-n-caproyl mesoisochlorin e₄

(D,L)-Serinyl pyropheophorbide a

Glycyl pyropheophorbide a

α-(D,L)-Alanyl pyropheophorbide a

β-Alanyl pyropheophorbide a

ε-Amino-n-caproyl pyropheophorbide a

(D,L)-Serinyl pheophorbide a

Glycyl pheophorbide a

α-(D,L)-Alanyl pheophorbide a

β-Alanyl pheophorbide a

ε-Amino-n-caproyl pheophorbide a

(D,L)-Serinyl photoprotoporphyrin IX

Glycyl photoprotoporphyrin IX

α-(D,L)-Alanyl-photoprotoporphyrin IX

β-Alanyl photoprotoporphyrin IX

ε-Amino-n-caproyl photoprotoporphyrin IX

Threoninyl chlorine₆

Tyrosyl chlorine₆

Valyl chlorine₆

Leucyl chlorine₆

Isoleucyl chlorine₆

Prolyl chlorine₆

Methionyl chlorine₆

Histidyl chlorine₆

Arginyl chlorine₆

Lysyl chlorine₆

Glutaminyl chlorine₆

4-Hydroxyprolyl chlorine₆

5-Hydroxylysyl chlorine₆

ε-Amino-n-caproyl chlorine₆

γ-Aminobutanoyl chlorine₆

3-Methyl histidyl chlorine₆

Alanyl-2-acetyl chlorine₆

Valyl-2-acetyl chlorine₆

Leucyl-2-acetyl chlorine₆

Isoleucyl-2-acetyl chlorine₆

prolyl-2-acetyl chlorine₆

Methionyl-2-acetyl chlorine₆

Glycyl-2-acetyl chlorine₆

Serinyl-2-acetyl chlorine₆

Threoninyl-2-acetyl chlorine₆

Cysteinyl-2-acetyl chlorine₆

Tyrosyl-2-acetyl chlorine₆

Asparginyl-2-acetyl chlorine₆

Lysyl-2-acetyl chlorine₆

Arginyl-2-acetyl chlorine₆

Histidyl-2-acetyl chlorine₆

Glutaminyl-2-acetyl chlorine₆

4-Hydroxyprolyl-2-acetyl chlorine₆

5-Hydroxylysyl-2-acetyl chlorine₆

ε-Amino-n-caproyl-2-acetyl chlorine₆

γ-Aminobutanoyl-2-acetyl chlorine₆

3-Methyl histidyl-2-acetyl chlorine₆

β-Alanyl-2-acetyl chlorine₆

Alanyl-2-formyl chlorine₆

Valyl-2-formyl chlorine₆

Leucyl-2-formyl chlorine₆

Isoleucyl-2-formyl chlorine₆

Prolyl-2-formyl chlorine₆

Methionyl-2-formyl chlorine₆

Glycyl-2-formyl chlorine₆

Serinyl-2-formyl chlorine₆

Threoninyl-2-formyl chlorine₆

Cysteinyl-2-formyl chlorine₆

Tyrosyl-2-formyl chlorine₆

Asparginyl-2-formyl chlorine₆

Lysyl-2-formyl chlorine₆

Arginyl-2-formyl chlorine₆

Histidyl-2-formyl chlorine₆

Glutaminyl-2-formyl chlorine₆

4-Hydroxyprolyl-2-formyl chlorine₆

5-Hydroxylysyl-2-formyl chlorine₆

ε-Amino-n-caproyl-2-formyl chlorine₆

γ-Aminobutanoyl-2-formyl chlorine₆

3-Methyl histidyl-2-formyl chlorine₆

β-Alanyl-2-formyl chlorine₆

Alanyl deuterochlorin e₆

Valyl deuterochlorin e₆

Leucyl deuterochlorin e₆

Isoleucyl deuterochlorin e₆

Prolyl deuterochlorin e₆

Methionyl deuterochlorin e₆

Glycyl deuterochlorin e₆

Serinyl deuterochlorin e₆

Threoninyl deuterochlorin e₆

Cysteinyl deuterochlorin e₆

Tyrosyl deuterochlorin e₆

Asparginyl deuterochlorin e₆

Lysyl deuterochlorin e₆

Arginyl deuterochlorin e₆

Histidyl deuterochlorin e₆

Glutaminyl deuterochlorin e₆

4-Hydroxyprolyl deuterochlorin e₆

5-Hydroxylysyl deuterochlorin e₆

6-Amino-n-caproyl deuterochlorin e₆

γ-Aminobutanoyl deuterochlorin e₆

3-Methyl histidyl deuterochlorin e₆

β-Alanyl deuterochlorin e₆

Valyl mesochlorin e₆

Leucyl mesochlorin e₆

Isoleucyl mesochlorin e₆

Prolyl mesochlorin e₆

Methionyl mesochlorin e₆

Serinyl mesochlorin e₆

Threoninyl mesochlorin e₆

Cysteinyl mesochlorin e₆

Tyrosyl mesochlorin e₆

Asparginyl mesochlorin e₆

Lysyl mesochlorin e₆

Arginyl mesochlorin e₆

Histidyl mesochlorin e₆

Glutaminyl mesochlorin e₆

4-Hydroxyprolyl mesochlorin e₆

5-Hydroxylysyl mesochlorin e₆

γ-Aminobutanoyl mesochlorin e₆

3-Methyl histidyl mesochlorin e₆

Porphyrin Derivatives:

(D,L)-Serinyl mesoporphyrin IX

Glycyl mesoporphyrin IX

α-(D,L)-Alanyl mesoporphyrin IX

β-Alanyl mesoporphyrin IX

ε-Amino-n-caproyl mesoporphyrin IX

(D,L)-Serinyl protoporphyrin IX

Glycyl protoporphyrin IX

α-(D,L)-Alanyl protoporphyrin IX

β-Alanyl protoporphyrin IX

ε-Amino-n-caproyl protoporphyrin IX

(D,L)-Serinyl deuteroporphyrin IX

Glycyl deuteroporphyrin IX

α-(D,L)-Alanyl deuteroporphyrin IX

β-Alanyl deuteroporphyrin IX

ε-Amino-n-caproyl deuteroporphyrin IX

(D,L)-Serinyl coproporphyrin III

Glycyl coproporphyrin III

α-(D,L)-Alanyl coproporphyrin III

β-Alanyl coproporphyrin III

ε-Amino-n-caproyl coproporphyrin III

(D,L)-Serinyl hematoporphyrin IX

Glycyl hematoporphyrin IX

α-(D,L)-Alanyl hematoporphyrin IX

β-Alanyl hematoporphyrin IX

ε-Amino-n-caproyl hematoporphyrin IX

Bacteriochlorin Derivatives:

(D,L)-Serinyl bacteriochlorin e₄

Glycyl bacteriochlorin e₄

α-(D,L)-Alanyl bacteriochlorin e₄

β-Alanyl bacteriochlorin e₄

ε-Amino-n-caproyl bacteriochlorin e₄

(D,L)-Serinyl bacterioisochlorin e₄

Glycyl bacterioisochlorin e₄

α-(D,L)-Alanyl bacterioisochlorin e₄

β-Alanyl bacterioisochlorin e₄

ε-Amino-n-caproyl bacterioisochlorin e₄

(D,L)-Serinyl bacteriochlorin e₆

Glycyl bacteriochlorin e₆

α-(D,L)-Alanyl bacteriochlorin e₆

β-Alanyl bacteriochlorin e₆

ε-Amino-n-caproyl bacteriochlorin e₆

(D,L)-Serinyl pyrobacteriopheophorbide a

Glycyl pyrobacteriopheophorbide a

α-(D,L)-Alanyl pyrobacteriopheophorbide a

β-Alanyl pyrobacteriopheophorbide a

ε-Amino-n-caproyl pyrobacteriopheophorbide a

(D,L)-Serinyl bacteriopheophorbide a

Glycyl bacteriopheophorbide a

α-(D,L)-Alanyl bacteriopheophorbide a

β-Alanyl bacteriopheophorbide a

ε-Amino-n-caproyl bacteriopheophorbide a

In the following, di- or polyamides of amino monocarboxylic acids are further exemplified,

Chlorin Derivatives:

Di-(D,L)-serinyl-trans-mesochlorin IX

Di-glycyl-trans-mesochlorin IX

Di-α-(D,L)-alanyl-trans-mesochlorin IX

Di-β-alanyl-trans-mesochlorin IX

Di-ε-amino-n-caproyl-mesochlorin IX

Di, tri-(D,L)-serinyl chlorine₆

Di, tri-(D,L)-serinyl mesochlorin e₆

Di, tri-glycyl chlorine₆

Di, tri-glycyl mesochlorin e₆

Di, tri-α-(D,L)-alanyl chlorine₆

Di, tri-α-(D,L)-alanyl mesochlorin e₆

Di, tri-β-alanyl chlorine₆

Di, tri-β-alanyl mesochlorin e₆

Di, tri-ε-amino-n-caproyl chlorine₆

Di, tri-ε-amino-n-caproyl mesochlorin e₆

Di-(D,L)-serinyl chlorine₄

Di-(D,L)-serinyl mesochlorin e₄

Di-(D,L)-serinyl isochlorin e₄

Di-(D,L)-serinyl mesoisochlorin e₄

Di-glycyl chlorine₄

Di-glycyl mesochlorin e₄

Di-Olycyl isochlorin e₄

Di-glycyl mesoisochlorin e₄

Di-α-(D,L)-alanyl chlorine₄

Di-α-(D,L)-alanyl mesochlorin e₄

Di-α-(D,L)-alanyl isochlorin e₄

Di-α-(D,L)-alanyl mesoisochlorin e₄

Di-β-alanyl chlorine₄

Di-β-alanyl mesochlorin e₄

Di-β-alanyl isochlorin e₄

Di-β-alanyl mesoisochlorin e₄

Di-ε-amino-n-caproyl chlorine₄

Di-ε-amino-n-caproyl mesochlorin e₄

Di-ε-amino-n-caproyl isochlorin e₄

Di-ε-amino-n-caproyl mesoisochlorin e₄

Di-(D,L)-serinyl photoprotoporphyrin IX

Di-glycyl photoprotoporphyrin IX

Di-α-(D,L)-alanyl-photoprotoporphyrin IX

Di-β-alanyl photoprotoporphyrin IX

Di-ε-amino-n-caproyl photoprotoporphyrin IX

Porphyrin Derivatives:

Di-(D,L)-serinyl mesoporphyrin IX

Di-glycyl mesoporphyrin IX

Di-α-(D,L)-alanyl mesoporphyrin IX

Di-β-alanyl mesoporphyrin IX

Di-ε-amino-n-caproyl mesoporphyrin IX

Di-(D,L)-serinyl protoporphyrin IX

Di-glycyl protoporphyrin IX

Di-α-(D,L)-alanyl protoporphyrin IX

Di-β-alanyl protoporphyrin IX

Di-ε-amino-n-caproyl protoporphyrin IX

Di-(D,L)-serinyl deuteroporphyrin IX

Di-glycyl deuteroporphyrin IX

Di-α-(D,L)-alanyl deuteroporphyrin IX

Di-β-alanyl deuteroporphyrin IX

Di-ε-amino-n-caproyl deuteroporphyrin IX

Di, tri, tetra-(D,L)-serinyl coproporphyrin III

Di, tri, tetra-glycyl coproporphyrin III

Di, tri, tetra-α-(D,L)-alanyl coproporphyrin III

Di, tri, tetra-β-alanyl coproporphyrin III

Di, tri, tetra-ε-amino-n-caproyl coproporphyrin III

Di-(D,L)-serinyl hematoporphyrin IX

Di-glycyl hematoporphyrin IX

Di-α-(D,L)-alanyl hematoporphyrin IX

Di-β-alanyl hematoporphyrin IX

Di-ε-amino-n-caproyl hematoporphyrin IX

Bacteriochlorin Derivatives:

Di-(D,L)-serinyl bacteriochlorin e₄

Di-glycyl bacteriochlorin e₄

Di-α-(D,L)-alanyl bacteriochlorin e₄

Di-β-alanyl bacteriochlorin e₄

Di-ε-amino-n-caproyl bacteriochlorin e₄

Di-(D,L)-serinyl bacterioisochlorin e₄

Di-glycyl bacterioisochlorin e₄

Di-α-(D,L)-alanyl bacterioisochlorin e₄

Di-β-alanyl bacterioisochlorin e₄

Di-ε-amino-n-caproyl bacterioisochlorin e₄

Di, tri-(D,L)-serinyl bacteriochlorin e₆

Di, tri-glycyl bacteriochlorin e₆

Di, tri-α-(D,L)-alanyl bacteriochlorin e₆

Di, tri-β-alanyl bacteriochlorin e₆

Di, tri-ε-amino-n-caproyl bacteriochlorin e₆

Similarly, using other amino acids, the following amides can be employed, however, they do not limit the present invention.

Di-threoninyl trans-mesochlorin IX

Di, tri-threoninyl chlorine₆

Di, tri-threoninyl mesochlorin e₆

Di-threoninyl chlorine₄

Di-threoninyl mesochlorin e₄

Di-threoninyl isochlorin e₄

Di-threoninyl mesoisochlorin e₄

Di-threoninyl photoprotoporphyrin IX

Di-threoninyl mesoporphyrin IX

Di-threoninyl protoporphyrin IX

Di-threoninyl deuteroporphyrin IX

Di, tri, tetra-threoninyl coproporphyrin III

Di-threoninyl hematoporphyrin IX

Di-threoninyl bacteriochlorin e₄

Di-threoninyl bacterioisochlorin e₄

Di, tri-threoninyl bacteriochlorin e₆

Di-cysteinyl trans-mesochlorin IX

Di, tri-cysteinyl chlorine₆

Di, tri-cysteinyl mesochlorin e₆

Di-cysteinyl chlorine₄

Di-cysteinyl mesochlorin e₄

Di-cysteinyl isochlorin e₄

Di-cysteinyl mesoisochlorin e₄

Di-cysteinyl photoprotoporphyrin IX

Di-cysteinyl mesoporphyrin IX

Di-cysteinyl protoporphyrin IX

Di-cysteinyl deuteroporphyrin IX

Di, tri, tetra-cysteinyl coproporphyrin III

Di-cysteinyl hematoporphyrin IX

Di-cysteinyl bacteriochlorin e₄

Di-cysteinyl bacterioisochlorin e₄

Di, tri-cysteinyl bacteriochlorin e₆

Di-tyrosyl trans-mesochlorin IX

Di, tri-tyrosyl chlorine₆

Di, tri-tyrosyl mesochlorin e₆

Di-tyrosyl chlorine₄

Di-tyrosyl mesochlorin e₄

Di-tyrosyl isochlorin e₄

Di-tyrosyl mesoisochlorin e₄

Di-tyrosyl photoprotoporphyrin IX

Di-tyrosyl mesoporphyrin IX

Di-tyrosyl protoporphyrin IX

Di-tyrosyl deuteroporphyrin IX

Di, tri, tetra-tyrosyl coproporphyrin

Di-tyrosyl hematoporphyrin IX

Di-tyrosyl bacteriochlorin e₄

Di-tyrosyl bacterioisochlorin e₄

Di, tri-tyrosyl bacteriochlorin e₆

Di-valyl trans-mesochlorin IX

Di, tri-valyl chlorine₆

Di, tri-valyl mesochlorin e₆

Di-valyl chlorine₄

Di-valyl mesochlorin e₄

Di-valyl isochlorin e₄

Di-valyl mesoisochlorin e₄

Di-valyl photoprotoporphyrin IX

Di-valyl mesoporphyrin IX

Di-valyl protoporphyrin IX

Di-valyl deuteroporphyrin IX

Di, tri, tetra-valyl coproporphyrin III

Di-valyl hematoporphyrin IX

Di-valyl bacteriochlorin e₄

Di-valyl bacterioisochlorin e₄

Di, tri-valyl bacteriochlorin e₆

Di-leucyl trans-mesochlorin IX

Di, tri-leucyl chlorine₆

Di, tri-leucyl mesochlorin e₆

Di-leucyl chlorine₄

Di-leucyl mesochlorin e₄

Di-leucyl isochlorin e₄

Di-leucyl mesoisochlorin e₄

Di-leucyl photoprotoporphyrin IX

Di-leucyl mesoporphyrin IX

Di-leucyl protoporphyrin IX

Di-leucyl deuteroporphyrin IX

Di, tri, tetra-leucyl coproporphyrin III

Di-leucyl hematoporphyrin IX

Di-leucyl bacteriochlorin e₄

Di-leucyl bacterioisochlorin e₄

Di, tri-leucyl bacteriochlorin e₆

Di-isoleucyl trans-mesochlorin IX

Di, tri-isoleucyl chlorine₆

Di, tri-isoleucyl mesochlorin e₆

Di-isoleucyl chlorine₄

Di-isoleucyl mesochlorin e₄

Di-isoleucyl isochlorin e₄

Di-isoleucyl mesoisochlorin e₄

Di-isoleucyl photoprotoporphyrin IX

Di-isoleucyl mesoporphyrin IX

Di-isoleucyl protoporphyrin IX

Di-isoleucyl deuteroporphyrin IX

Di, tri, tetra-isoleucyl coproporphyrin III

Di-isoleucyl hematoporphyrin IX

Di-isoleucyl bacteriochlorin e₄

Di-isoleucyl bacterioisochlorin e₄

Di, tri-isoleucyl bacteriochlorin e₆

Di-prolyl trans-mesochlorin IX

Di, tri-prolyl chlorine₆

Di, tri-prolyl mesochlorin e₆

Di-prolyl chlorine₄

Di-prolyl mesochlorin e₄

Di-prolyl isochlorin e₄

Di-prolyl mesoisochlorin e₄

Di-prolyl photoprotoporphyrin IX

Di-prolyl mesoporphyrin IX

Di-prolyl protoporphyrin IX

Di-prolyl deuteroporphyrin IX

Di, tri, tetra-prolyl coproporphyrin III

Di-prolyl hematoporphyrin IX

Di-prolyl bacteriochlorin e₄

Di-prolyl bacterioisochlorin e₄

Di, tri-prolyl bacteriochlorin e₆

Di-phenylalanyl trans-mesochlorin IX

Di, tri-phenylalanyl chlorine₆

Di, tri-phenylalanyl mesochlorin e₆

Di-phenylalanyl chlorine₄

Di-phenylalanyl mesochlorin e₄

Di-phenylalanyl isochlorin e₄

Di-phenylalanyl mesoisochlorin e₄

Di-phenylalanyl photoprotoporphyrin IX

Di-phenylalanyl mesoporphyrin IX

Di-phenylalanyl protoporphyrin IX

Di-phenylalanyl deuteroporphyrin IX

Di, tri, tetra-phenylalanyl coproporphyrin III

Di-phenylalanyl hematoporphyrin IX

Di-phenylalanyl bacteriochlorin e₄

Di-phenylalanyl bacterioisochlorin e₄

Di, tri-phenylalanyl bacteriochlorin e₆

Di-tryptophyl trans-mesochlorin IX

Di, tri-tryptophyl chlorine₆

Di, tri-tryptophyl mesochlorin e₆

Di-tryptophyl chlorine₄

Di-tryptophyl mesochlorin e₄

Di-tryptophyl isochlorin e₄

Di-tryptophyl mesoisochlorin e₄

Di-tryptophyl photoprotoporphyrin IX

Di-tryptophyl mesoporphyrin IX

Di-tryptophyl protoporphyrin IX

Di-tryptophyl deuteroporphyrin IX

Di, tri, tetra-tryptophyl coproporphyrin III

Di-tryptophyl hematoporphyrin IX

Di-tryptophyl bacteriochlorin e₄

Di-tryptophyl bacterioisochlorin e₄

Di, tri-tryptophyl bacteriochlorin e₆

Di-methionyl trans-mesochlorin IX

Di, tri-methionyl chlorine₆

Di, tri-methionyl mesochlorin e₆

Di-methionyl chlorine₄

Di-methionyl mesochlorin e₄

Di-methionyl isochlorin e₄

Di-methionyl mesoisochlorin e₄

Di-methionyl photoprotoporphyrin IX

Di-methionyl mesoporphyrin IX

Di-methionyl protoporphyrin IX

Di-methionyl deuteroporphyrin IX

Di, tri, tetra-methionyl coproporphyrin III

Di-methionyl hematoporphyrin IX

Di-methionyl bacteriochlorin e₄

Di-methionyl bacterioisochlorin e₄

Di, tri-methionyl bacteriochlorin e₆

Di-histidyl trans-mesochlorin IX

Di, tri-histidyl chlorin e₆

Di, tri-histidyl mesochlorin e₆

Di-histidyl chlorine₄

Di-histidyl mesochlorin e₄

Di-histidyl isochlorin e₄

Di-histidyl mesoisochlorin e₄

Di-histidyl photoprotoporphyrin IX

Di-histidyl mesoporphyrin IX

Di-histidyl protoporphyrin IX

Di-histidyl deuteroporphyrin IX

Di, tri, tetra-histidyl coproporphyrin III

Di-histidyl hematoporphyrin IX

Di-histidyl bacteriochlorin e₄

Di-histidyl bacterioisochlorin e₄

Di, tri-histidyl bacteriochlorin e₆

Di-arginyl trans-mesochlorin IX

Di, tri-arginyl chlorine₆

Di, tri-arginyl mesochlorin e₆

Di-arginyl chlorine₄

Di-arginyl mesochlorin e₄

Di-arginyl isochlorin e₄

Di-arginyl mesoisochlorin e₄

Di-arginyl photoprotoporphyrin IX

Di-arginyl mesoporphyrin IX

Di-arginyl protoporphyrin IX

Di-arginyl deuteroporphyrin IX

Di, tri, tetra-arginyl coproporphyrin III

Di-arginyl hematoporphyrin IX

Di-arginyl bacteriochlorin e₄

Di-arginyl bacterioisochlorin e₄

Di, tri-arginyl bacteriochlorin e₆

Di-lysyl trans-mesochlorin IX

Di, tri-lysyl chlorine₆

Di, tri-lysyl mesochlorin e₆

Di-lysyl chlorine₄

Di-lysyl mesochlorin e₄

Di-lysyl isochlorin e₄

Di-lysyl mesoisochlorin e₄

Di-lysyl photoprotoporphyrin IX

Di-lysyl mesoporphyrin IX

Di-lysyl protoporphyrin IX

Di-lysyl deuteroporphyrin IX

Di, tri, tetra-lysyl coproporphyrin III

Di-lysyl hematoporphyrin IX

Di-lysyl bacteriochlorin e₄

Di-lysyl bacterioisochlorin e₄

Di, tri-lysyl bacteriochlorin e₆

Di-glutaminyl trans-mesochlorin IX

Di, tri-glutaminyl chlorine₆

Di, tri-glutaminyl mesochlorin e₆

Di-Olutaminyl chlorine₄

Di-glutaminyl mesochlorin e₄

Di-glutaminyl isochlorin e₄

Di-glutaminyl mesoisochlorin e₄

Di-glutaminyl photoprotoporphyrin IX

Di-glutaminyl mesoporphyrin IX

Di-glutaminyl protoporphyrin IX

Di-glutaminyl deuteroporphyrin IX

Di, tri, tetra-glutaminyl coproporphyrin III

Di-glutaminyl hematoporphyrin IX

Di-glutaminyl bacteriochlorin e₄

Di-glutaminyl bacterioisochlorin e₄

Di, tri-glutaminyl bacteriochlorin e₆

Di-asparginyl trans-mesochlorin IX

Di, tri-asparginyl chlorine₆

Di, tri-asparginyl mesochlorin e₆

Di-asparginyl chlorine₄

Di-asparginyl mesochlorin e₄

Di-asparginyl isochlorin e₄

Di-asparginyl mesoisochlorin e₄

Di-asparginyl photoprotoporphyrin IX

Di-asparginyl mesoporphyrin IX

Di-asparginyl protoporphyrin IX

Di-asparginyl deuteroporphyrin IX

Di, tri, tetra-asparginyl coproporphyrin III

Di-asparginyl hematoporphyrin IX

Di-asparginyl bacteriochlorin e₄

Di-asparginyl bacterioisochlorin e₄

Di, tri-asparginyl bacteriochlorin e₆

In the following, mono-, di- or polyamides of amino dicarboxylic acids are exemplified.

Chlorin Derivatives:

Mono and diaspartyl trans-mesochlorin IX

Mono and diglutamyl trans-mesochlorin IX

Mono, di and triaspartyl chlorine₆

Mono, di and triaspartyl mesochlorin e₆

Mono, di and triglutamyl chlorine₆

Mono, di and triglutamyl mesochlorin e₆

Mono and diaspartyl chlorine₄

Mono and diaspartyl mesochlorin e₄

Mono and diaspartyl isochlorin e₄

Mono and diaspartyl mesoisochlorin e₄

Mono and diglutamyl chlorine₄

Mono and diglutamyl mesochlorin e₄

Mono and diglutamyl isochlorin e₄

Mono and diglutamyl mesoisochlorin e₄

Monoaspartyl pyropheophorbide a

Monoglutamyl pyropheophorbide a

Monoaspartyl pheophorbide a

Monoglutamyl pheophorbide a

Mono and diaspartyl photoprotoporphyrin IX

Mono and diglutamyl photoprotoporphyrin IX

Mono and di-L-a-aminoadipyl trans-mesochlorin IX

Porphyrin Derivatives:

Mono and diaspartyl mesoporphyrin IX

Mono and diglutamyl mesoporphyrin IX

Mono and diaspartyl protoporphyrin IX

Mono and diglutamyl protoporphyrin IX

Mono and diaspartyl deuteroporphyrin IX

Mono and diglutamyl deuteroporphyrin IX

Mono, di, tri and tetraaspartyl coproporphyrin III (isomer mixture)

Mono, di, tri and tetraglutamyl coproporphyrin III

Mono and diaspartyl hematoporphyrin IX

Mono and diglutamyl hematoporphyrin IX

Bacteriochlorin Derivatives:

Mono and diaspartyl bacteriochlorin e₄

Mono and diglutamyl bacteriochlorin e₄

Mono and diaspartyl bacterioisochlorin e₄

Mono and diglutamyl bacterioisochlorin e₄

Mono, di and triaspartyl bacteriochlorin e₆

Mono, di and triglutamyl bacteriochlorin e₆

Monoaspartyl pyrobacteriopheophorbide a

Monoglutamyl pyrobacteriopheophorbide a

Monoaspartyl bacteriopheophorbide a

Monoglutamyl bacteriopheophorbide a

The tetrapyrrole compounds used in the present invention can be prepared by various synthetic methods which are found in the literatures. For example, the following literatures are exemplified with regard to chlorinc e₆.

(1) Willstatter, R. and Stoll, A.; "Investigations on Chlorophyll", (Trans.: Schertz, F. M., Merz, A. R.), p. 176, Science Printing Press, Lancaster, Pa., U.S.A., 1928.

(2) Willstatter, R. and Isler, M.; Ann. Chem., 390, 269 (1912).

The compounds employed in the present invention are useful for the photodynamic diagnosis and photodynamic therapy of rheumatoid arthritis. When a man or a mammal animal having rheumatoid arthritis is treated with doses of the above-mentioned compound, the compound is selectively accumulated in the arthritic lesion and when light rays of proper wavelength and intensity are applied to the lesion, the compound generates fluorescence and produces active oxygen. Thereby the arthritic lesion being diagnosed by inspecting the generated fluorescence and the affected lesion is cured by the cytotoxic effect of active oxygen.

The host of a living body to be dosed is a mammal having rheumatoid arthritis in its body.

The compounds used for the photodynamic diagnosis and photodynamic therapy should have the following properties:

(a) non-toxic at normal diagnostic or therapeutic dosage unless and until activated by light rays;

(b) should be accumulated selectively in arthritic lesions;

(c) should be selectively photoactive on specific wavelengths;

(d) when irradiated with light rays or electromagnetic waves, they generate detectable specific fluorescence;

(e) when irradiated with light rays or electromagnetic waves, they are activated to cytotoxic level in arthritic lesion; and

(f) easily metabolized or excreted after the diagnosis and therapeutic treatment.

The foregoing compounds as the diagnostic or therapeutic agents used in the present invention must have the above properties and are also characterized by the reasonable solubility in water at physiological pH.

As compared with the use of conventional tetrapyrroles such as the foregoing hematoporphyrin derivative of Photofrin II, the above-described compounds generate fluorescence of greater intensity in arthritic lesions with the same quantities of doses. Accordingly, with the use of the above-mentioned compounds, the arthritic lesion provides more intense contrast as compared with the normal tissue around the arthritic lesion.

Furthermore, the intensity of fluorescence which is generated from some conventionally used tetrapyrroles varies or the fluorescence generated in the body of host varies from day to day, however, the intensity of fluorescence generated by the above compounds is quite stable.

The compounds used in the present invention absorb activation energy for the photodynamic diagnosis and photodynamic therapy in the range of 300 to 800 nm in wavelength, with the preferred compound absorbing in the 360 to 760 nm, i.e., the light of longer wavelength which more readily permits penetration of energy into the arthritic lesion for facilitating the purpose of photodynamic diagnosis and photodynamic therapy.

Incidentally, the specific wavelength of fluorescence which is emitted from the compound used in the present invention that is accumulated in the arthritic lesion is shifted by about 10 nm as compared with that of the same compound in a phosphate buffered saline solution. From this fact, it is considered that the compound used in the present invention is not physically caught simply within the arthritic lesion but it is connected to the lesion by some interconnection mechanism. When the wavelength is shifted, the change in the intensity of fluorescence is also caused to occur usually. However, in the case of the foregoing compounds, the intensity of fluorescence is not weakened but rather strengthened. Accordingly, the above-mentioned compounds are most suitable for the photodynamic diagnosis and photodynamic therapy.

According to the experience until now, the quantity of dosage can be reduced considerably because the above-mentioned compounds are uniformly distributed all around the arthritic lesion. Because the quantity of dosage can be reduced, it is possible to suppress the occurrence of photodynamic sensitization in a host even when the administered compound is not excreted.

The quantity of administration of the fore.going compound is determined depending on the purpose of dosage. FOr the purpose of diagnosis, a dosage of only 1 mg/kg (weight of living body) produces an effect for detection. The quantity is, however, generally up to about 5 mg/kg. The quantity of dosage for the therapeutic purpose is generally in the range of about 0.1 to 20 kg/mg. The quantity of the administration for diagnosis and therapy can be varied in a wide range in view of the above-mentioned advantage that the compound used in the present invention is liable to be excreted from a living body. The compound of the present invention is apparently innocuous with the dose for the above-described diagnostic and therapeutic purpose. For example, no test animal was killed owing to the compound used in the present invention in experiments with the doses up to 20 mg/kg.

A compound used in the present invention which is dissolved in an appropriate aqueous solution such as a phosphate buffered saline solution is administered by a proper method to the living body of a host to be diagnosed or treated. Besides the aqueous solution, it can be an aqueous dispersion containing a suitable dispersing agent. It is preferable that the medical compound is administered by a direct method such as intravenous injection. Meanwhile, the oral, intramuscular or hypodermic administration is also possible. It is also possible to administer the compound directly into the joint cavity. In any case, the solution of the above-mentioned compound may also contain the following known materials: a binder such as gum tragacanth; an excipient such as dicalcium phosphate; a disintegrating agent such as corn starch; a lubricant such as magnesium stearate; a sweetening agent such as sucrose; a preservative such as paraben; a dye; a flavoring such as cherry flavor; a solvent or dispersion medium such as water, ethanol or glycol; an antiseptic; and an isotonic agent such as sugar and sodium chloride.

These compounds can be prepared for use as preferable basic salts, for example, sodium salts in the form of lyophilized pyrogen-free sterile compounds. The preferable type of the medical agent is an isotonic solution usable for injection.

Although the reason has not been clear, the compounds used in the present invention are specifically and selectively accumulated in the arthritic lesion (hyperplastic synovial membrane) in a living body. Accordingly, after the passage of a proper time, for example, in several minutes to several hours after the administration into a vein, light rays are applied to the arthritic lesion.

The irradiation must be an amount sufficient to cause the compound to generate fluorescence for diagnosis and also to exert a cytotoxic effect for therapy. The light source for the irradiation in the photodynamic diagnosis and photodynamic therapy is not limited, however, a laser beam is generally used because an intense light ray within a desired wavelength range can be applied selectively.

Usable sources for the irradiation of laser beams are a strong continuous light source through a filter, an exited dye laser or other laser apparatus, and transmitted beam system. As described above, the wavelength of the laser beam is in the range of 360 to 760 nm. The intensity of irradiation is appropriately selected generally from the range of 10 to 1000 mW/cm² preferably 20 to 500 mW/cm². The capacity of the laser apparatus is at least 500 mW. Some of commercially available laser apparatus meets these requirements.

In the practice of photodynamic diagnosis, the above-mentioned compound is administered to the body of human or animal and, after a certain period of time, light rays are applied to the lesion to be inspected. When a arthroscope can be used for the lesion in elbow or knee joints, the irradiation is done using the arthroscope. The lesion of rheumatoid arthritis selectively generates fluorescence, which lesion can be observed directly by naked eyes or with an image on a CRT screen.

In the practice of photodynamic therapy, the laser beam irradiation is carried out from the tip end of a quartz fiber bundle after administering the compound. This can be done by inserting the tip end of quartz fiber bundle into the arthritic lesion as well as by irradiating the surface of arthritic lesion. The irradiated state is observed directly by naked eyes or with an image on a CRT screen.

The diagnosis and therapy using the foregoing medical agents can be applied to the diseases which causes the growth or inflammation of the synovial membrane in a joint cavity such as the diseases causing arthritis, diseases similar to rheumatoid arthritis or complications of rheumatoid arthritis. For example, the analogous diseases of juvenile rheumatoid arthritis, systemic lupus erythematosus, Reiter's syndrome, psoriatic arthritis, and pigmented villonodular synovitis.

In the following, the present invention is described in more detail with examples of medical effect tests concerning the above-mentioned medical compounds.

Photodynamic diagnosis and photodynamic therapy were carried out by administering the above-mentioned compounds to rats affected with adjuvant induced arthritis (herein after referred to as "A. A. rat". The A. A. rats had arthritic lesions which closely resemble the human rheumatoid arthritis in morphological and biochemical characteristics.

Mono-L-aspartyl chlorin e₆ (hereinafter referred to as "NPe6") was used as a test compound.

As a compound to be compared with, photofrin II (trademark, made by Photofrin Medica Inc.) was used. These compounds were employed by dissolving them in a phosphate buffer solution (pH 7.4).

PREPARATION EXAMPLE 1 Preparation of Mono-L-Aspartyl Chlorin e₆

Chlorin e₆ was prepared according to the procedure described in Fischer and Stern, Di Chemie Des Pyrroles, Vol. II, second half, Leipzig 1940, Akademische Verlagsgesellschaft, pp. 91-93.

150 mg of chlorine₆ (free acid form) and 250 mg of L-aspartic acid di-tert-butyl ester hydrochloride were dissolved in 20 ml of dimethyl formamide. There was made a total of 3-100 mg additions of N,N'-dicyclohexylcarbodiimide at one hour intervals. After 4 hours, the reaction mixture was diluted with 300 ml ether, washed twice with 200 ml H₂ O, then extracted with 40 ml 1M KOH. The KOH solution was allowed to hydrolyze overnight, then heated to 70° C. for 10 minutes.

The pH of the solution was adjusted to 7, then any residual ether was removed by flash evaporation. The solution was then applied to a reverse phase (C-18 silica) column (1.5 cm φ×30 cm). The product was purified by a stepwise elution of methanol/0.01M KPO₄ buffer (pH 6.85). Eluted with 5% methanol until unwanted polar pigments were removed. Monoaspartyl chlorin e₆ was eluted off with 6-8% methanol, and unreacted chlorin e₆ was removed with 25% methanol.

The product was precipitated at pH 3 after flash evaporating briefly to remove methanol, then washed by the centrifuge 3 times with dilute acetic acid.

The product was dried under vacuum. Yield of mono-L-aspartyl chlorin e₆ was 50 mg.

PREPARATION EXAMPLE 2 Preparation of Mono-L-Serinyl Chlorin e₆

The chlorin e₆ prepared in the like manner as in Preparation Example 1 was used. 100 mg of the chlorine e₆ and 35 mg of 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide hydrochloride were dissolved in 2 ml of N,N'-dimethyl formamide. After 5 minutes, 125 mg of L-serine benzyl ester hydrochloride was added, stirred vigorously until solution was complete, then allowed to stand at room temperature for 2 hours. At this time, 0.5 ml of glacial acetic acid was added, then 30 ml of methanol and 12 ml of H₂ O.

The solution was applied to a C-18 reverse phase column. The column was washed with 100 ml of H₂ O, then 4 ml of 1M NH₄ OH, then 50 ml of H₂ O again. Eluted the product with MeOH/H₂ O. Fractions eluted from the column with 30% to 80% MeOH contained product as well as carbodiimide-activated chlorin as determined by TLC on C-18 reverse phase plates with a solvent of 70% MeOH/30% buffer (0.1M sodium phosphate pH 6.85) V/V.

These fractions were pooled and enough 3 N NaOH was added to make the solution 0.1N in NaOH. After 1 hour, the hydrolysis was complete as determined by TLC in the above system. Removed the methanol by rotary evaporation and adjusted the pH of the solution to 7.5 with HCl. The chlorin solution was then reapplied to the same reverse phase column, washed with water, and eluted with MeOH/water using a stepwise gradient solution from 10 to 50% methanol. The fractions containing pure mono-L-serinyl chlorin e₆ as determined by TLC (Rf slightly greater than the unsubstituted chlorin e₆) were pooled, the methanol was removed by rotary evaporation, and the product was dried as the trisodium salt by lyophilization.

Animal Test

Normal Lewis system LEW/Crj rats (supplied by Japan Charles River) which took artificial rheumatoid arthritis were used for experiments as A. A. rats. These rats are suitable for the tests of this kind because they correspond well to the diseases of mankind.

Adjuvant (0.6 mg/animal) of Mycobacterium tuberculosis H37 RA, made by Difco, was applied to the foot pads of right hind legs of male Lewis system LEW/Crj rats of 8 weeks of age. After the inoculation, the reddening and swelling of legs occurred within 24 hours. After 2 to 3 weeks, chronic proliferative periostitis occurred around joints to exhibit the chronic arthritis.

In the experiments, five rats were used for each group of diagnostic test or therapeutic test with each treating agent, respectively.

Test Apparatus

The apparatus for these experiments included a catheter of 2.1 mm in diameter (made by Sumitomo Electric Industries, Ltd.), an argon dye laser (made by Spectrum Physics) for exciting photosensitive substance and a fluorescence spectrum analyzer system. The wavelengths of the argon dye laser for exciting photosensitive substance could be adjusted to 405 nm, 630 nm or 664 nm corresponding to the absorption bands of the respective substances and it was used at an irradiation dose of 100 mW/cm². This laser beam was introduced into a quartz fiber bundle of 300 μm in core diameter and it was then passed through the catheter.

Example of Diagnosis 1

After 1, 2, 3 and 4 weeks from the inoculation of adjuvant, A. A. rats were administered with a test compound in an amount of 1 mg per 1 kg body weight through a vein of the tail. Six hours after the administration, the knee joint of right hind leg which was inoculated with the adjuvant was cut open under the anesthesia with Nembutal and a laser beam of 405 nm was applied to the lesion using a endoscopic catheter through which the laser beam was passed. The specific fluorescence spectrum generated by the substance taken in the affected lesion (hyperplastic synovial membrane) was observed by a fluorescence analyzer. The intensity of fluorescence was calculated from the integrated area on fluorescence spectrum in the range of 600-700 nm and the obtained values were adopted as criteria for accumulated compounds.

After the photodynamic diagnosis, the animals were sacrificed under anesthesia, the knee joints were resected and served for the specimens. The specimens were subjected to histologic inspection with hematoxylin-eosin stain to compare the intensity of fluorescence and the degree of inflammation.

Normal rats of the same weeks of age were used as basic controls. As comparative examples, the A. A. rats in similar conditions of disease were administered with Photofrin II and they were subjected to similar tests.

Example of Therapeutic Treatment 1

According to the therapeutic conditions indicated in Table 3, three weeks after the inoculation of adjuvant, A. A. rats were administered with test compounds in an amount of 0.5 mg per 1 kg body weight through a vein in the tail. Six hours after the administration, the knee joint of right hind leg which was inoculated with the adjuvant was cut open under the anesthesia with Nembutal and a laser beam was applied directly to the joint cavity. The specific fluorescence spectrum generated by the substance taken in the affected lesion (hyperplastic synovial membrane) was observed by a fluorescence analyzer. The therapeutic treatment was then carried out by applying 50 J/cm² of 405 nm to 664 nm laser beam to the affected lesion in which it was observed that sufficient quantity of the compound was taken. After the treatment, the incision was sutured and an antibiotic was injected in the wound and joint cavity and the rats were bred for 1 week. One week after the treatment, 1 mg/kg of the same test compounds were administered and photodynamic diagnosis was done. After the diagnosis, the animals were sacrificed under anesthesia and the knee joints were resected and served for the specimens. The specimens were subjected to histologic inspection with hematoxylin-eosin stain to compare the intensity of fluorescence and the degree of inflammation.

The A. A. rats in similar conditions of disease were applied with 50 J/cm² without administering the test compound were used as controls. As comparative examples, the A. A. rats in similar conditions of disease were administered with Photofrin II and they were subjected to similar tests.

                  TABLE 3                                                          ______________________________________                                         Method of Therapeutic Treatment                                                                         Laser    Laser  Irradi-                                       Dose    Time(*)  Wavelength                                                                              Intensity                                                                             ation                                 Compound                                                                               mg/kg   hrs      nm       mW/cm.sup.2                                                                           J/cm.sup.2                            ______________________________________                                         Photo-  0.5     6        405      100    50                                    frin II                                                                        Photo-  0.5     6        630      100    50                                    frin II                                                                        NPe.sub.6                                                                              0.5     6        405      100    50                                    NPe.sub.6                                                                              0.5     6        664      100    50                                    Control --      --       664      100    50                                    ______________________________________                                          (*)Time length from dosage to irradiation                                

Test Result 1

The results of Diagnosis 1 are described in the following.

Each compound was administered to A. A. rats of 3 weeks after the inoculation of adjuvant, which rats suffered from adjuvant arthritis. A laser beam was applied to knee joint and the intensity of fluorescence of the compound in the knee joint was determined by photodynamic diagnosisThe results are shown in Table 4.

As a result, the intensity of fluorescence in the group of Photofrin II in the arthritic lesion (hyperplastic synovial membrane) was 3.5, meanwhile the value was 1.2 in other cartilage of normal tissue. In Achilles tendon and muscle of normal tissue, the values were 0.5. On the other hand, the intensity of fluorescence in the group of NPe₆ in the arthritic lesion (hyperplastic synovial membrane) was 16.0, meanwhile the value was 1.0 in other cartilage of normal tissue. In Achilles tendon and muscle of normal tissue, the values were 0.2.

In the normal rats of the same week of age, the intensity of fluorescence of Photofrin II group in the normal synovial membrane was 0.2, and the fluorescence was not detected in other normal tissues of cartilage, Achilles tendon and muscle. Also, the intensity of fluorescence of NPe₆ group in the normal synovial membrane was 0.2, and the fluorescence was not detected in other normal tissues of cartilage, Achilles tendon and muscle.

                  TABLE 4                                                          ______________________________________                                         Fluorescence Intensities in Photodynamic Diagnosis                             in Various Tissues Including Affected Lesion                                   (Hyperplastic Synovial Membrane)                                                                Medical Agent                                                 Tissue             Photofrin II                                                                              NPe.sub.6                                        ______________________________________                                         Adjuvant Arthritis Rats                                                        Affected Lesion    3.5        16.0                                             (Hyperplastic                                                                  Synovial membrane)                                                             Cartilage          1.2        1.0                                              Achilles tendon    0.5        0.2                                              Muscle             0.5        0.2                                              Normal Rats                                                                    Affected Lesion    0.2        0.2                                              Cartilage          0.0        0.0                                              Achilles tendon    0.0        0.0                                              Muscle             0.0        0.0                                              ______________________________________                                    

Similar diagnosis was carried out by administering NPe₆ to A. A. rats which were different in the degree of inflammation with the passage of 1 to 4 weeks after the inoculation of adjuvant. By measuring intensities of fluorescence, the correlation between the measured intensities and the degree of inflammation in the histological diagnosis was investigated. The results are shown in Table 5.

The fluorescence intensity of synovial cells of 1 week after the adjuvant inoculation was 2.0. Almost no fluorescence was observed in other normal tissues of cartilage, Achilles tendon and muscle. According to the histological diagnosis on the same lesions, the growth of synovial cells was not so large and the cartilage was normal (+1). The swelling of right leg which was inoculated with adjuvant was slight.

The fluorescence intensity of synovial cells of 2 weeks after the adjuvant inoculation was 10.5. Almost no fluorescence was observed in other normal tissues of cartilage, Achilles tendon and muscle. According to the histological diagnosis on the same lesions, the growth of synovial cells was observed (+4) and the degree of swelling was more than 2 times the normal value.

The fluorescence intensities of synovial cells of 3 and 4 weeks after the adjuvant inoculation were 16.0 in both cases. In other normal tissues, the values were 1.0 in cartilage and 0.2 in Achilles tendon and muscle. According to the histological diagnosis on the same lesions, the growth of synovial cells was intense and the buildup of villi and the formation of pannus due to granulation (+5) were observed. The swelling was more than 2 times the normal value. The above observation indicates the arthritis due to the adjuvant arthritis.

As described above, the fluorescence intensity of NPe₆ has a correlation to the degree of adjuvant arthritis. Accordingly, the degree of inflammation can be determined by comparing the intake of NPe₆.

                  TABLE 5                                                          ______________________________________                                         Fluorescence Intensity of NPe.sub.6 vs. Degree of                              Rheumatoid Arthritis and Results of Diagnosis                                  ______________________________________                                                    Weeks of Age of A. A. Rats                                                     after Inoculation of Adjuvant                                                    0 week   1      2     3     4                                     Test Item    (Normal) week   weeks weeks weeks                                 ______________________________________                                         Intensity of                                                                   Fluorescence                                                                   Cartilage    0.0      0.0    0.2   1.0   1.0                                   Achilles tendon                                                                             0.0      0.0    0.0   0.2   0.2                                   Muscle       0.0      0.0    0.0   0.2   0.2                                   Synovial Membrane                                                                           0.0      2.0    10.5  16.0  16.0                                  Results of Diagnosis                                                           Histological.sup.(1)                                                                        ±0    +1     +4    +5    +5                                    Diagnosis                                                                      Degree of.sup.(2)                                                                           5.5      7.5    12.5  13.0  13.0                                  Swelling                                                                       ______________________________________                                         Notes:                                                                         .sup.(1) Histological Diagnosis:                                               The degree of the growth of synovial cells in the affected                     lesion and the formation of pannus.                                            Evaluation:                                                                    ±0:                                                                              Indicates the state of normal form and quantity of                             synovial cells and normal cartilage.                                      ↓                                                                       +5:  Indicates the state of hyperplastic synovial cells                             and formation of pannus.                                                  .sup.(2) Degree of Swelling:                                                   The diameter (mm) of a right leg which was inocu-                              lated with adjuvant.                                                      

Test Result 2

The results of Therapeutic Treatment 1 are described in the following.

Each compound was administered to A. A. rats of 3 weeks after the inoculation of adjuvant, which rats suffered from rheumatoid arthritis. Photodynamic diagnosis was carried out by applying a laser beam to a knee joint cavity so as to confirm the sufficient intake of the medical agent. The therapeutic treatment was done by irradiating the affected lesion (hyperplastic synovial membrane) with 50 J/cm² of laser beam. One week after the treatment, the same medical agent was administered for photodynamic diagnosis, thereby comparing the obtained value with the value before the therapeutic treatment. The results are shown in the following Table 6.

As a result, the intensities of fluorescence in Photofrin II group in the affected lesion were 3.5 to 3.6 before the therapeutic treatment and 1.8 to 2.0 after the treatment. Meanwhile, the intensities of fluorescence in NPe₆ group in the affected lesion were 16.0 to 16.2 before the treatment and 1.9 to 2.4 after the treatment.

In the A. A. rats with the same disease without the dose of medical agent, fluorescence was not observed in both before and after the therapeutic treatment.

In the group of Photofrin II, the average ratio of fluorescence intensities after the therapeutic treatment to those before the treatment in the affected lesions was 54%. Meanwhile, in the group of NPe₆, the average ratio was as low as 13%. Accordingly, it was ascertained that the degree of inflammation could be alleviated more effectively in the group of NPe₆ by the therapeutic treatment as compared with 14 the cases in the group of Photofrin II.

                  TABLE 6                                                          ______________________________________                                         Fluorescence Intensities of Medical Agents                                     before and after Photodynamic Therapy in                                       Affected Lesion (Hyperplastic Synovial Membrane)                                          Item                                                                          Wave.sup.(1)                                                                           Fluorescence Intensity.sup.(2)                                           Length    Before    After                                          Medical Agent                                                                              (nm)      Treatment Treatment                                      ______________________________________                                         Photofrin II                                                                               405       3.5       2.0                                            Photofrin II                                                                               630       3.6       1.8                                            NPe.sub.6   405       16.0      2.4                                            NPe.sub.6   664       16.2      1.9                                            No Dosage   664       0.0       0.0                                            ______________________________________                                          Notes:                                                                         .sup.(1) Wavelength: The wavelength of applied laser beam used for the         therapeutic treatment.                                                         .sup.(2) Fluorescence Intensity:                                               The intensities of fluorescence which was observed by photodynamic             diagnosis in treated lesions at the times before the treatment and 1 week      after the treatment.                                                     

Shown in Table 7 are the comparative results of histological diagnosis and ocular diagnosis with preparing tissue specimens of treated lesions. In the therapy group of Photofrin II, slight changes in synovial cells were observed without any significant difference and marked therapeutic effect was not obtained (+3).

On the other hand, in the therapy group of NPe₆, synovial cells were subjected to vacuolation or atrophy and the exfoliation of synovial cells was observed. Owing to the above effect, the swelling was relieved and the improvement in the affected lesion was observed (±0 to +1 ).

In the group of NPe₆ applying laser beams of two kinds of 405 nm and 664 nm in wavelength gave similar high therapeutic effects.

In the group of no dosage for the A. A. rats of similar condition of disease, no change of affected lesion was observed by the irradiation with 50 J/cm² laser beam (+5).

As described above, the therapeutic effect in the group of NPe₆ was high as compared with the effect in the group of Photofrin II and the alleviation and improvement of rheumatoid arthritis were apparently observed.

                  TABLE 7                                                          ______________________________________                                         Results of Photodynamic Therapy                                                ______________________________________                                         Medical                                                                               Wavelength.sup.(1)                                                                        Intensity of.sup.(2)                                                                      Histological.sup.(3)                                                                    Ocular.sup.(4)                           Agent  (nm)       Fluorescence                                                                              Diagnosis                                                                               Diagnosis                                ______________________________________                                         Photo- 405        2.0        +3       +3                                       frin II                                                                        Photo- 630        1.8        +3       +3                                       frin II                                                                        NPe.sub.6                                                                             405        2.4        +1       +1                                       NPe.sub.6                                                                             664        1.9        ±0    ±0                                    No     664        0.0        +5       +5                                       Dosage                                                                         ______________________________________                                         Notes:                                                                         .sup.(1) Wavelength:                                                           The wavelength of laser beam for the irradiation of therapeutic                treatment.                                                                     .sup.(2) Intensity of Fluorescence:                                            The intensity of fluorescence in the treated lesion which was                  observed by photodynamic diagnosis carried out 1 week after the                therapeutic treatment.                                                         .sup.(3) Histological Diagnosis:                                               The degree of the hyperplasia of synovial cells in the affected                lesion and the formation of pannus.                                            Evaluation:                                                                    ±0:                                                                              Indicates the state of normal form and quantity of                             synovial cells and normal cartilage.                                      ↓                                                                       +5:  Indicates the state of hyperplastic synovial cells                             and formation of pannus.                                                  .sup.(4) Ocular Diagnosis (Degree of swelling):                                Indicates the degree of swelling and changes observed by visual                observation.                                                                   Evaluation:                                                                    ±0:                                                                              Indicates that the diameter of right leg is in                                 normal value.                                                             ↓                                                                       +5:  Indicates the swollen right leg and accompanying                               functional disorder.                                                 

Concerning the above compounds, the test of acute toxicity among toxicological properties was carried out.

NPe₆ was intravenously administered to rats (strain: Sprague-Dawley) to determine the 50% lethal dose (LD₅₀). The value of LD₅₀ in male was 176 mg/kg and 184 mg/kg in female. The LD₅₀ values in the intravenous administration to mice (strain: C3H/HEJ) were 214 mg/kg in male and 187 mg/kg in female.

SUMMARY OF TEST RESULTS

(1) The photodynamic therapy using NPe₆ was found to be effective for the regression of rheumatoid arthritis and for the curing of lesion. In comparison with the treatment using the known Photofrin II, a higher therapeutic effect (regression of arthritic lesion) can be expected when the same quantities of treating agents are administered to the arthritic lesion on the same degree of disease.

(2) In the photodynamic diagnosis with NPe₆, more excellent selective intake in comparison with Photofrin II in the arthritic lesion was confirmed. Even when a small dose of the compound was used, it could identify the arthritic lesion, thereby enabling to concentrate the treatment effect specifically to the arthritic lesion.

(3) The fluorescence intensity of NPe₆ was correlative to the degree of seriousness of rheumatoid arthritis. Accordingly, the degree of disease can be determined by comparing the intake amount of NPe₆.

(4) In the use of NPe₆, the treatment with laser beams of either 405 nm or 664 nm in wavelength corresponding to its absorption bands, can provide high therapeutic effects.

EFFECT OF THE INVENTION

The above-described compound was administered to mammals which were suffered from arthritis and photodynamic diagnosis and photodynamic therapy were carried out. As a result, the following effects were ascertained.

(1) The disease can be diagnosed and treated directly and exactly because the medical compound is selectively accumulated in the arthritic lesion.

(2) One week after the therapeutic treatment, synovial membrane in abnormal growth in a joint is subjected to vacuolation or atrophy and the swelling is relieved.

(3) In comparison with the conventionally used Photofrin II or the like, more distinct therapeutic effect can be expected when the same quantities of medical agents are used for arthritic lesions of the same degree in seriousness. 

What is claimed is:
 1. A method for the diagnosis of arthritis of mammals, which comprises administering to a mammal an effective amount of a fluorescent tetrapyrrole compound that accumulates in an arthritic lesion within said mammal and applying light of sufficient wavelength and intensity to produce fluorescence in said arthritic lesion, wherein said tetrapyrrole compound is selected from the group consisting of tetrapyrrole carboxylic acids having at least one carboxyl group represented by the following general formula, and corresponding dihydrotetrapyrrole or tetrahydrotetrapyrrole carboxylic acids, and monoamides, diamides and polyamides of said tetrapyrrole carboxylic acids with amino-monocarboxylic acids or dicarboxylic acids, and their pharmacologically acceptable salts: ##STR12## wherein, R₁ is methyl ##STR13## R₂ is H, vinyl, ethyl, --CH(OH)CH₃, acetyl, ##STR14## --CH₂ CH₂ COOH or ═CHCHO; R₃ is methyl, ##STR15## R₄ is H, vinyl, ethyl, --CH(OH)CH₃, --CH₂ CH₂ COOH, ═CHCHO or ##STR16## R₅ is methyl; R₆ is H, --CH₂ CH₂ COOH, --CH₂ CH₂ COOR or --COOH;R₇ is --CH₂ CH₂ COOH, --CH₂ CH₂ COOR or ##STR17## R₈ is methyl or ##STR18## R₉ is H, --COOH, --CH₂ COOH or methyl; provided that when R₁, R₂, R₃, R₄, R₇ and R₈ represent two substituents or are divalent and attached to the same carbon, the respective pyrrole ring to which attached is a dihydropyrrole; R is lower alkyl or benzyl; R₆ and R₉, taken together are ##STR19## with the proviso that at least one of R₁ to R₉ is a free carboxyl group.
 2. The method as claimed in claim 1, wherein the lesion to be diagnosed by said method is a hyperplastic granulation of synovial membrane in a joint.
 3. The method as claimed in claim 1, wherein the wavelength of said light is about 300 nm to about 800 nm.
 4. The method as claimed in claim 3, wherein said wavelength is about 360 nm to about 760 nm.
 5. The method as claimed in claim 1, wherein the intensity of said light is about 10 mW/cm² to about 1000 mW/cm².
 6. The method as claimed in claim 1, wherein the dose of said tetrapyrrole compound is about 0.1 to 20 mg/kg.
 7. The method as claimed in claim 1, wherein said amino-monomonocarboxylic acids or dicarboxylic acids are natural α-amino-monocarboxylic acids or α-amino-dicarboxylic acids.
 8. The method as claimed in claim 1, wherein said tetrapyrrole carboxylic acid has at least 3 carboxyl groups.
 9. The method as claimed in claim 8, wherein said tetrapyrrole carboxylic acid is represented by the following general formula: ##STR20## wherein, X is H, vinyl, ethyl, acetyl or formyl; Y is methyl or formyl; M is methyl; and E is ethyl. 